Inflammation of the ears in a child can be triggered by many causes caused by external or internal damage to the ear, the ingress of small objects into the ear canal, or an infectious lesion of the hearing organ. Pediatricians call otitis media the most common ENT disease of preschool children. About the main causes of ear inflammation in a child, the symptoms and treatment of pathology - in detail in the article.
Causes of otitis media
Features of the anatomical structure of the child's auditory canal is such that any liquids entering the short and somewhat deformed passages of the middle ear, for the most part, remain in the cavities behind the eardrum. The created humid environment is favorable for the development of bacterial flora. Any inflammatory process of the respiratory tract, associated with swelling of the ENT system and abundant nasal discharge, by default becomes the main risk factor for the formation of an acute condition called otitis media.
Rhinitis in children, if it is not a consequenceallergic rhinitis, most often occurs in the off-season, therefore, an increase in the statistics of ear diseases is noted mainly in the autumn-spring period. Inflammation of the ears in a child - under the general name "otitis media" - is divided into several forms:
- Otitis externa is provoked by a microbial environment, the focus of which is located on the surface of the ear canal mucosa. Pathological flora penetrates the ear through microdamages, but actively develops only in case of a reduced immune response of the body, which must be taken into account when drawing up a treatment regimen.
- Inflammation of the middle ear in a child is a consequence of respiratory diseases or severe hypothermia. Acute inflammation in half of the cases is characterized by a purulent formation with the release of exudate from the ear canal.
- Internal ear inflammation in a child occurs in case of complications caused by purulent otitis media. The disease develops in the absence of treatment or in the case of using the wrong tactics of therapy in acute form of otitis media.
Other causes of otitis media in children are the following provoking factors:
- incorrect position of the baby when feeding or bathing, during which liquid food and water enter the baby's ears;
- low immunity;
- out-of-season baby clothes;
- lack of breastfeeding in early infancy;
- Smoking adults in the presence of the baby.
Elimination of these factors reduces the likelihood of ear inflammation in a child inseveral times.
Symptomatics and treatment of otitis externa
The onset of the disease may go unnoticed, because with otitis externa there is no severe pain, but parents should pay attention to the fact that the child from time to time pulls himself by the ear and holds his head slightly to one side. If you press your finger on the disturbing area, the baby shows anxiety.
Other possible symptoms of ear infections in children:
- redness of the auricle or skin around the ear;
- on close examination, tubercles and swelling are visible in the ear canal;
- there is inflammation of the lymph nodes behind the ear in a child.
If a child is naughty while eating or tries to swallow food without chewing first, and at the same time he has a stable subfebrile body temperature (in some cases it may not be), then there is a reason to suspect the presence of an ear boil. It is possible to notice inflammation with the naked eye if a dense brown boil is located near the auricle. Furuncle, far located in the ear canal, is not diagnosed at home. You should know that latent ear furunculosis can cause inflammation of the lymph nodes behind the ear in a child.
It is necessary to start treatment of furunculosis before the child's condition is alleviated by an independent breakthrough of the boil. The contents of the abscess spread deep into the auditory canal and can cause a secondary inflammatory process. Treatment of ear inflammation in a child with otitis externa caused by furunculosis is subject totraditional pattern:
- treatment of the inflamed area with antiseptic ointments until the top of the purulent rod appears on the head of the boil;
- application of alcohol compresses on the abscess (if necessary);
- opening the boil after its full formation, followed by disinfecting treatment;
- application with regenerating ointment (for example, Levomekol) with frequent change of compresses.
When diagnosing a purulent lesion of the lymph nodes and the presence of staphylococcal or streptococcal pathogens in the body, a course of antibiotics is mandatory. In parallel - for taking a long course - the child is prescribed immunomodulatory drugs of plant origin (for example, "Immunal" containing echinacea).
Signs, treatment and effects of otitis media
Inflammation of the middle ear in a child is accompanied by vivid symptoms, in the bouquet of which the most distinctive feature can be called acute, paroxysmal pain (this is called "shooting"). The suffering of the baby is aggravated by swallowing, so he may cry when feeding; older children will refuse to eat and drink. Sometimes you can notice lymphatic inflammation under the ear in a child. The size of the node may be insignificant, but pain is felt on palpation.
The peak of an acute condition with otitis media occurs at night and is accompanied by a sharp rise in body temperature. In rare cases, the child vomits, and traces of pus can be seen in the auricle.yellowish color. Most often, purulent exudate is reserved in the middle ear of a child, and the inflammation is not so noticeable externally. In addition, the very presence of pus in otitis media is debatable.
Treatment of inflammation of the middle ear in a child is based on the use of anti-inflammatory and antibiotic agents, as well as drugs whose action is aimed at relieving acute symptoms:
- decongestant nasal drops;
- antipyretics;
- analgesics.
Otitis media of any kind is dangerous with complications. Its most complex form is purulent, which, with inappropriate treatment or ignoring symptoms, can lead to irreversible hearing loss and deformation of the tissues of the ear canal. This happens when the exudate - instead of leaving the ear canal, accumulates in the cavity of the middle ear and starts the adhesive process (reservation of thick pus).
Another critical complication of otitis media in children, the symptoms of which repeat the second, most severe stage of the disease after a long pause in remission, is mastoiditis. Stagnation of pus with mastoiditis in the absence of surgical intervention threatens the development of such irreversible processes as brain abscess, deafness (complete or partial), paralysis of the facial nerves.
Chronic otitis media
Most often, chronic otitis media is the result of a poorly cured form of acute inflammation, but in rare cases, the disease develops on its own and in a matter of days. In early childhoodage, the formation of chronic otitis media often occurs against the background of severe scarlet fever. Other causes of pathology may be recently transferred or present in a constant sluggish mode of the disease (condition):
- diabetes mellitus;
- meningitis;
- congenital pathologies of the auditory canal;
- presence of another focus of infection in the nasopharyngeal apparatus;
- low immunity.
Symptoms of chronic ear inflammation in a child (pictured below) are implicit. She may be completely absent. At the moments of relapse, the disease abruptly, without any transition, changes from a sluggish position to an acute one, which responds well to therapy, and the illusion of a complete cure is created.
Chronic otitis is of two types:
- benign - the disease does not spread beyond the middle ear cavity and can proceed for many years without obvious complications;
- malignant - the pathological process spreads to the bone walls of the ear canal, deforming and destroying them.
Even the release of purulent exudate in chronic otitis is almost never accompanied by discomfort or pain. Parents only notice over time that the child began to hear worse. They turn to a specialist when it is no longer possible to reverse the process.
How to treat inflammation of the ear in children with an exacerbation of the chronic form? The same medications that are used in the treatment of otitis media are suitable. It is very important - especially in case of repeated relapse - to consult an immunologist with a sick childand follow all his instructions.
First aid for otitis media
Children under three years of age are practically unable to correctly tell about their feelings and indicate exactly where they hurt, but even a small child with otitis media will cry a lot, turn his head restlessly, pull his ear, rub his neck or temporal region. To clarify the diagnosis and provide emergency assistance to the baby before the doctor arrives, the mother needs to take the baby in her arms, and when he calms down, press your finger on the protruding cartilage in front of the child's ear (tragus). With otitis, the baby will cry or show anxiety with a sharp movement.
The sequence of actions of parents in case of suspected ear inflammation in a child should be as follows:
- instillations with nasal vasoconstrictor drops (preferably those used previously);
- if the baby cries non-stop or has a high fever, then it is necessary to give a drug from the group of antipyretics with an analgesic effect ("Nurofen", "Ibuprofen");
- when a purulent substance is discharged from the ear, moisten a cotton swab with 3% hydrogen peroxide, roll it with a flagellum and carefully remove the exudate without introducing the turunda deep into the auditory canal;
- After emergency measures are taken, a thin woolen cap or cotton scarf is put on the child's head (if it is warm at home).
Other ways to help a child before he is examined by a doctor are strictly prohibited. In no case should you independently instill with ear drops or apply to the patientarea with warm compresses. With a purulent course of the disease, this will only increase the inflammatory process and worsen the condition of the child.
Folk treatments for otitis media in children
Many parents, after agreeing this issue with the pediatrician, try to speed up the process of the child's recovery with the help of alternative methods of treating otitis media. The use of home remedies is not an alternative to traditional drugs, but can significantly reduce the likelihood of complications.
Several recipes from the folk piggy bank:
- If the child is not allergic to bee products, it is recommended to use propolis infused with alcohol in a ratio of 1:15. The tincture aged for 10 days is diluted with refined vegetable oil (1:6), cotton turundas are moistened with this composition and placed in the patient's ears for 12-18 hours.
- A child over 5 years old can put a cotton swab dipped in fresh onion juice in the ear.
- Dry wormwood color (1 teaspoon) is poured with a quarter glass of vodka and infused for 7-10 days. Cotton turundas are soaked with the finished medicine and placed in the baby's ears for 2-3 hours to reduce pain.
- They take 10 whole bay leaves, rub them with their hands into crumbs and pour the raw material with a liter of boiling water. After half an hour, the resulting infusion can be used for drinking and for instillation into the ears.
- From an intact leaf of a three-year-old aloe, juice with pulp is squeezed out, passed through 4 layers of gauze and the resulting liquid is injected into the earschild 1 drop three times a day.
After the instillations, it is recommended to warm the head and ears of the child with a hat. Alcohol, aloe, or onion-based products should not be used if the child has an ear canal injury or a deformity of the eardrum.
Treatment of otitis according to Komarovsky
Speaking about the treatment of otitis media in children, Dr. Komarovsky opposes using the same methods of therapy for all forms of this many-sided disease. He also categorically disagrees with the spontaneous prescription of antibiotics after the initial diagnosis of pathology and before the pediatrician receives the results of the tests. What is it about?
The fact is that antibiotics only help if the disease is of bacterial origin. They are absolutely useless, even harmful, if the pathogenic flora of inflammation does not contain a bacterial infectious agent. At what types of otitis media is it necessary to prescribe antibacterial drugs:
- catarrhal (assign "Sumamed", "Augmentin");
- purulent;
- external, with furunculosis.
Prescribe antibiotics if the child's condition is not very serious, 2-3 days after the onset of the disease.
A well-known pediatrician recommends that parents insist on hospitalization of a preschool child in case of diagnosing purulent otitis media. Often, to completely remove the viscous substance from the middle ear cavity, a surgical puncture is required, whichmust be done in a timely manner. It is almost impossible to determine the relevance of this procedure when the child is on home treatment. Thus, the favorable time for the operation may be missed.
Dr. Komarovsky's recommendations for the prevention of otitis media
According to Dr. Komarovsky, inflammation of the ear in a child in 8 cases out of 10 can be prevented by reasonable prevention. If the baby often catches a cold, it is necessary twice a year - in spring and autumn - to make an appointment with an immunologist and carefully follow his appointments.
Every day, the child needs to walk in the fresh air in clothes appropriate for the weather and season. Walks should be active and take place before, not after, eating. During dangerous periods of viral epidemics, the time for festivities must be reduced, but at the same time, the living quarters must be ventilated more often.
Prevention of otitis media includes more specific advice from an authoritative doctor:
- Daily cleaning of the ears should be done with dry cotton swabs, not ear buds;
- when feeding or drinking, the baby's head should be well above the level of his stomach;
- from the age of three, a child already needs to be taught how to blow his nose;
- during games, you need to make sure that the baby does not put small objects, pencils in his ears.
If a child attends a kindergarten, attentive parents should make sure that the airing of the group is carried out by educators strictly according to the established schedule and only in the absence of children. The ability of a preschooler to dress is also of great importance.independently, since this process in kindergarten is happening rapidly. Such a detail as a poorly tied cap on a child may go unnoticed.
Rehabilitation treatment after otitis media
After curing a neglected or purulent form of otitis media, parents may notice that the child's hearing has become worse. This is manifested in the fact that during a conversation he tries to turn his he althy ear to the speaker, often asks again or speaks louder than usual. As a rule, this condition is temporary and disappears in less than a month after the victory over the disease. If this does not happen, the otolaryngologist after the examination may recommend the following procedures:
- blowing ear canals;
- exposure to the tympanic membrane by air currents of variable strength;
- electrophoresis;
- iontophoresis;
- oxygenobarotherapy.
Therapeutic exercises that have no contraindications, which can be turned into a fun game, have proven themselves well. All manipulations should be performed 7-10 times in children under 5 years old and 10-15 times in preschoolers and younger students. Exercises are performed in the following sequence:
- with bent and slightly tense fingers tap on the outside of the auricle;
- tightly press palms to ears, count to 10 and abruptly remove hands;
- close the auditory canals of the ears with index fingers, and then abruptly release, simultaneously opening the mouth in a silent pronunciation of the sound “o”.
"Exercise for the ears" can be repeated many times during the day. Harmthere will be no such frequency.
In early childhood, even mild hearing loss can have serious consequences. Hearing-impaired children perceive information worse, develop more slowly, have a lower reaction rate, so restoring the child's auditory functions after suffering otitis media should be a priority for parents.
Inflammation of the behind-the-ear lymph nodes and earlobe
Inflammation of the lymph nodes behind the ear in a child can be observed in older preschool age, when the lymphatic system of a small person has already completed its formation. It must be understood that the very phenomenon of subcutaneous protrusion of a peripheral organ is not an independent disease and always implies a reaction of the body to latent pathogenic processes. The causes of inflammation of the lymph nodes behind the ear in a child are varied:
- growth of pathogenic tissues;
- immune response of the body to the penetration of foreign cells;
- penetration of streptococcal or staphylococcal pathogens through microtraumas;
- brucellosis and others
Often this symptom is reinforced by fever, headache, nausea and weakness. If a combination of these signs is observed, then we are talking, most likely, about suppuration of the lymph node. The completion of home diagnostics in this case will be palpation. When probing the tubercle on the skin, pits from the fingers will be clearly indicated. The appointment of therapeutic measures for suppuration of the lymph nodes is engaged ininfectious disease specialist.
Another often voiced problem in the office of a pediatric ENT doctor is inflammation of the child's earlobe. If the appearance of painful sensations was preceded by a visit to the beauty parlor and a piercing of the earlobe, then the doctor will advise you to treat the injured area with local antiseptics several times during the day. In addition, experts recommend refusing to put earrings made of cheap materials into the child's ears, which quickly oxidize and cause an immediate reaction of the body in the form of a painful rash and suppuration.
